Subjective Grading Research Articles

A phase 1 dose-escalation study of GCC19CART: A novel CAR T-cell therapy for metastatic colorectal cancer in the United States.

175 Background: GCC19CART, the first clinical candidate from the CoupledCAR solid tumor platform, pairs solid tumor CAR T-cells with CD19-targeting CAR T-cells to enhance proliferation, activation, and persistence against solid tumors. GCC19CART targets guanylate cyclase-C (GCC), a known mucosal marker. Building on the promising results from a clinical trial in China, a phase 1 study was initiated in the US for patients with metastatic colorectal cancer (mCRC) refractory to standard chemotherapy. As of August 14, 2024, a total of 9 subjects have been treated. Methods: Subjects were initially screened for GCC expression, however screening was discontinued after >95% of subjects with mCRC demonstrated GCC expression by immunohistochemistry (95/98). Eligible subjects underwent leukapheresis, lymphodepleting chemotherapy (fludarabine 30mg/m 2 and cyclophosphamide 300mg/m 2 on day-3), and then infusion of a single dose GCC19CART. Objective response was assessed by RECIST v1.1. Results: Four subjects have been enrolled at dose level 1 (1x10 6 cells/kg) and 5 subjects at dose level 2 (2x10 6 cells/kg). The most common adverse events were cytokine release syndrome (CRS) in 9/9 subjects (Grade 1: 6/9 [66.7%] and Grade 2: 3/9 [33.3%]) and diarrhea in 8/9 subjects (Grade 1: 3/9 [33.3%], Grade 2: 3/9 [33.3%], Grade 3: 2/9 [22.2%]). Immune effector cell-associated neurotoxicity syndrome (ICANS) occurred in 2/9 subjects (Grade 2: 1/9 [11.1%] or Grade 3: 1/9 [11.1%]) and resolved rapidly with corticosteroid and dasatinib treatment. Three out of 9 subjects had a mild tremor (Grade 1) that resolved with corticosteroids. One subject experienced a dose-limiting toxicity (DLT) at dose level 2, presenting with Grade 3 diarrhea, Grade 4 enterocolitis and Grade 5 sepsis, and died from fungal sepsis 48 days post-infusion. At dose level 1, the overall response rate (ORR) was 50.0% (2/4). Two subjects demonstrated a partial response (PR) with one confirmed PR, while 1 additional subject had partial metabolic response on PET/CT with stable disease (SD) and 1 patient had progressive disease. At dose level 2, the ORR was 80% (4/5), including 1 subject with a pathological complete response, and 3 with a confirmed partial response, of which 1 had a complete metabolic response on PETCT. Conclusions: Preliminary results indicate that GCC19CART exhibits significant clinical activity in patients with refractory mCRC. Adverse events were related to GCC19CART mechanism and in line with what has been observed with other CAR T-cell products. Strategies to further optimize the management of treatment-related diarrhea are currently being implemented. The trial is ongoing and updated data will be presented. Clinical trial information: NCT05319314 .

Discriminatory power of trabeculectomy bleb internal reflectivity and morphology in surgical success using anterior segment optical coherence tomography

BackgroundThe post-operative evaluation of trabeculectomy blebs has traditionally relied on subjective clinical grading systems performed at the slit-lamp. This study explores the use of swept source anterior-segment optical coherence tomography (AS-OCT) to objectively measure bleb internal reflectivity and morphology, and to distinguish blebs with surgical success vs. failure.MethodsCross-sectional study of patients with glaucoma who had undergone trabeculectomy at least one year prior. Swept source AS-OCT was used to capture filtering blebs in the sagittal plane. Standardised regions of interests on the sagittal plane were segmented, and pixel intensity values and bleb height were measured. Receiver operating characteristic curves were used to examine the discriminatory ability of pixel intensity values and bleb morphology to classify blebs with surgical success or failure.Results100 eyes of 65 patients were included, with a median post-operative follow up of 7.0 years (IQR 3.2–16 years). The proportion of complete success, qualified success and failure was 45%, 33%, and 22% respectively. The maximum bleb height was significantly greater in the blebs with complete success (1.74 vs. 1.25 vs. 1.23 mm in CS vs. QS vs. F, one-way ANOVA, p < 0.0001). Mean pixel intensity was significantly lower in blebs with complete success (150.8 vs. 157.4 vs. 167.4 in CS vs. QS vs. F, p = 0.0001). Bleb intensity standard deviation (AUC 0.81), maximal bleb height (AUC 0.76), mean pixel intensity (AUC 0.75) and minimum pixel intensity (AUC 0.75) offered the best discrimination between surgical success and failure.ConclusionsSwept-source AS-OCT can be used to quantify bleb internal reflectivity and morphology, which can be used to distinguish between well vs. poorly functioning blebs. These parameters may assist surgeons in the objective evaluation of post-operative bleb outcomes.

Mindmeister’s Influence on 4C Skills in Indonesian Subject Grade 6 Elementary School in Surabaya

This study aims to determine the influence of MindMeister on 4C skills in the Indonesian language subject in grade 6 elementary school in Surabaya. A combined research method was used, involving data collection carried out through in-depth interviews with students, observation, taking pre-test and post-test scores 3 times each in the control class and experimental class. Quantitative results showed no significant effect of using MindMeister on 4C skills (significance values of 0,100 &gt; 0,05). However, the qualitative result based on the student's perspective gained through interviews and observations is that most students can apply 4C skills while using MindMeister. In conclusion, it is proposed that MindMeister may influence 4C skill levels in the Indonesian subject in this particular context. It is hoped that these findings contribute to the use of MindMeister in other subjects in any grade of elementary school in Indonesia.

Clinical study of colorViz fusion image vascular grading based on multi-phase CTA reconstruction in acute ischemic stroke

ObjectiveThis study aimed to evaluate the diagnostic value of ColorViz fused images from multi-phase computed tomography angiography (mCTA) using GE Healthcare’s FastStroke software for newly diagnosed cerebral infarctions in patients with acute ischemic stroke (AIS).MethodsA total of 106 AIS patients with unilateral anterior circulation occlusion were prospectively enrolled. All patients underwent mCTA scans during the arterial peak phase, venous peak phase, and venous late phase. The vascular information from these mCTA phases was combined into a time-varying color-coded image using GE Healthcare’s FastStroke software. All participants also underwent magnetic resonance diffusion-weighted imaging (MR-DWI) within three days. The diagnostic capability of the mCTA ColorViz fusion images for identifying newly diagnosed intracranial infarction was assessed using MR-DWI as the gold standard, focusing on the degree of delayed vascular perfusion and the number of visible blood vessels.ResultsThe mCTA ColorViz fusion images revealed ischemic changes in brain tissue, demonstrating a sensitivity of 88.7% for superficial infarctions and 48.5% for deep infarctions. Additionally, the subjective vascular grading score of the mCTA ColorViz fusion images showed a strong negative correlation with the infarct area identified by MR-DWI (r = − 0.6, P < 0.001).ConclusionThe mCTA ColorViz fusion images produced by FastStroke software provide valuable diagnostic insights for newly diagnosed cerebral infarction in AIS patients. The sensitivity of these images is notably higher for superficial infarctions compared to deep ones. This technique allows for relatively accurate detection of the ischemic extent and the likelihood of infarction in the superficial regions where lesions are located.

Development Of Interactive Learning Media Petar (Directions) Using Canva On Indonesian Language Subjects Grade IV Elementary School

This research was a development research that aimed to produce interactive PETAR (Direction Guide) learning media for the Indonesian Language subject for grade IV of Elementary School. The development model used referred to the ADDIE model which includes analysis, design, development, implementation and evaluation activities. The results of the study showed : (1) the media produced was the interactive PETAR (Direction Guide) learning media (2) the interactive PETAR (Direction Guide) learning media was declared feasible by media experts, language experts and material experts with an average percentage of 96% in the very feasible category (3) the interactive PETAR (Direction Guide) learning media was declared practical based on the practicality observation sheet with the category “very practical; (4) the interactive PETAR (Direction Guide) learning media was declared effective in improving student learning at the media trial stage, observation sheets and questionnaires with the results of improving learning obtained “very high” category and improving learning abilities obtaining “very good” category. There is a significant difference in student learning before and after using the interactive PETAR (Direction Guide) learning media. Thus, this finding confirms that the interactive learning media PETAR (Direction Guide) can be an effective alternative in improving student learning in directions material.

DETERMINATION OF PARATHYROID FUNCTION AFTER TOTAL THYROIDECTOMY BY OBJECTIVE ANALYSIS OF ITS FLUORESCENCE INTENSITY WITH INDOCYANINE GREEN USING PURPOSE DEVELOPED COMPUTER SOFTWARE

BackgroundTransient postoperative hypocalcaemia is the most common complication following total thyroidectomy. This study explores the correlation between indocyanine green (ICG)-parathyroid fluorescence and parathyroid glandular function post-total thyroidectomy, employing a novel, purpose-built computer software for objective and intraoperative measurement of fluorescence intensity. MethodsA prospective, single-center study was conducted on patients undergoing total thyroidectomy. Parathyroid gland fluorescence intensity after ICG administration in individuals experiencing post-thyroidectomy hypocalcaemia was compared with those without hypocalcaemia. Objective determination of fluorescence intensity using the dedicated computer program was contrasted with subjective analog grading scales. ResultsAnalysis of data from 61 patients revealed that the software-based objective determination of parathyroid fluorescence intensity offered superior predictive value for postoperative normocalcaemia (NPV=95,8%, AUC=0,784, p<0,001) compared to intraoperative PTH gradient (NPV=77,5%, AUC=0,780, p<0,001) and subjective fluorescence intensity determination (NPV=91,3%, AUC=0,762, p=0,001). Additionally, the software-based assessment emerged as the strongest independent predictor of postoperative normocalcaemia (OR=41,791, p=0,001), surpassing the predictive power of PTH gradient (OR=12,472, p=0,004). ConclusionsIntraoperative identification of a single high-intensity fluorescent parathyroid gland using the bespoke computer software is demonstrated to be a reliable predictor, allowing for the avoidance of postoperative hypocalcaemia following total thyroidectomy. This novel approach holds promise for improving surgical outcomes in thyroidectomy procedures.

Meibography health score: a simple grading system for isotretinoin-induced meibography alterations on patients with acne vulgaris.

To develop a simple, subjective, and reliable grading scale for isotretinoin-induced meibography changes. After analyzing meibography images obtained from systemic isotretinoin users, a grading scale was proposed and named "meibography health score." The score ranged from 1 to 3, with decreasing gland reflectivity and identifiable margins. A total of 11 medical professionals were asked to grade 10 meibography images obtained from isotretinoin users using the proposed scale and were divided into three groups: (A) ophthalmologists with experience with meibography, (B) ophthalmologists with no experience with meibography, and (C) radiologists. The kappa statistic was determined to test interrater reliability. The overall kappa was approximately 0.64. The kappa scores for Groups A, B, and C were 0.78, 0.59, and 0.90, respectively. Grade 2 had the lowest kappa scores (0.62, 0.35, and 0.82 for A, B, and C, respectively) and grade 3 the highest (0.78, 0.90, and 1.0 for A, B and C, respectively). Furthermore, Group C had the highest kappa scores and Group B the lowest. The meibography health score exhibited good interrater reliability, particularly in severe cases.

Shapeshifting in Social Spaces: Sociolinguistic Competence of Multilingual Learners

The study aims to determine the sociolinguistic competence level of the multilingual Grade 10 learners at Buhisan Night High School for the Academic Year 2024-2025. Terogo et al. (2018), stated that even though students have been shown to gain exceptional grades in English subjects, they fall short in sociolinguistic competence since it is not practiced more often in the Philippines. Thus, assessing sociolinguistic competence is important as well as addressing the low-level sociolinguistic competency of the learners through an action plan. A descriptive quantitative research method was used to determine the sociolinguistic competence level of the multilingual 48 student-respondents. The researcher adapted a TOIEC test and used a researcher-made questionnaire to assess the learners’ sociolinguistic competence. A weighted average mean was used to determine their proficiency and sociolinguistic competence level. Based on the results of the study, situational judgment got the highest rank while reading comprehension got the lowest rank in terms of the learners’ proficiency level. However, the study revealed that the respondents got a general weighted average of 15.83 which means that the respondents’ sociolinguistic competence level is under “Basic Sociolinguistic Competence” which is below the passing rate with a percentage of 58.63. The study recommends enhancing students’ sociolinguistic competence through the integration of sociolinguistic competence in language teaching through enhancement activities and exercises such as role-playing, dialogues and situational exercises, and future researchers may use the findings as a basis for future research or conduct related studies to enhance the sociolinguistic competence of Filipino multilingual learners.

THE APPLICATION OF THE VALUES OF THE PROFIL PELAJAR PANCASILA IS CONCEPT OF KURIKULUM MERDEKA IN THE SUBJECT OF IPAS

This study aims to determine the application of the profil pelajar Pancasila is concept kurikulum merdeka in IPAS subjects at SDN 55 Bima City. This research uses a qualitative descriptive method with the subject of the principal, IPAS subject teacher and grade IV students. The data collection techniques used by researchers to obtain the necessary data are; interviews, observation and documentation. The results of this study indicate that SDN 55 Kota Bima has implemented the values of the Pancasila learner profile at school well, both in the IPAS subject in grade IV and applied to habituation and school culture. The values of the Pancasila learner profile in question are faith, devotion to God Almighty and noble character, global diversity, cooperation, independence, creativity, and critical reasoning.

Outcome Measures after Peripheral Nerve Injury: Past, Present and Future.

Peripheral nerve injuries (PNI) present substantial challenges due to variability in injury severity and limited regenerative capabilities. Historically, PNI research has focussed on measures such as subjective surgeon outcome grading, two-point discrimination (2PD) and the Medical Research Council (MRC) grading system. While these methods have use, there are also limitations related to subjectivity and sensitivity. Electrophysiological studies, including electromyography (EMG) and nerve conduction studies (NCS), provide detailed insights but are invasive and resource intensive. Currently, the landscape of outcome measurements in PNI research is diverse, incorporating a mix of surgeon-scored, patient-reported and objective measures. Advancements in wearable devices and motion-tracking technologies offer the potential for continuous, real-time monitoring of patient recovery. These innovations can provide a more comprehensive and objective view of functional recovery, moving beyond the limitations of periodic clinical assessments. The primary limitation in current PNI research is the lack of standardisation in outcome measures and the arbitrary timing of assessments. This variability complicates data interpretation and comparative effectiveness research. Standardising the selection and timing of outcome measures is crucial for enhancing the reliability of research findings and facilitating collaborative studies. Level of Evidence: Level V (Diagnostic).

Optimizing assessment workload and student experience: a quantitative and qualitative analysis of an undergraduate subject restructure.

Optimizing the workload of university students is important for their academic performance and student experience. Large perceived workloads are associated with poorer academic performance and lower student satisfaction in university students.x In response to student feedback in 2021, we redesigned a second-year undergraduate physiology subject to optimize workload and improve student experience. The practical assessments (contributing 50% of the subject grade) were consolidated from five small reports to two more comprehensive reports. The new subject design resulted in a 3.85% reduction in practical assessment marks (P < 0.05), although students maintained their academic performance on the end of the trimester quiz. Upon reflection, the new practical assessments may have been more challenging for students and more discriminating of academic performance, as they required greater levels of critical thinking and more in-depth discussion of complex physiological concepts. Student satisfaction was reduced following the first iteration of the new subject design, but with additional assessment support for students by academic staff in 2022, the student experience ratings were no longer below expected values. In summary, consolidating the number of practical assessments was predicted to foster deeper learning of physiological concepts. However, to successfully achieve this, support from academic staff appears to be an essential factor to foster a positive student experience.NEW & NOTEWORTHY We showed that reducing the number of assessment submissions did not initially decrease students' perceived workload. Rather, producing more support materials for assessments and holding more support sessions by academic staff appeared to be most effective at fostering a positive student experience and students' perception of academic workload.

Quantitative assessment of cervical disc degeneration using disc signal intensity index.

The assessment of disc degeneration remains a significant challenge in clinical research. Pfirrmann grade is a frequently used classification for lumbar disc degeneration on MRI. However, there has been no gold standard for cervical spine disc degeneration. Recently, we introduced the Disc Signal Intensity Index (DSI2) as a quantitative disc assessment for the lumbar spine, which is easily measurable in the cervical spine. The aim of this study was to apply DSI2 in the cervical intervertebral disc and investigate the factors associated with the cervical disc degeneration. Cross-sectional study using retrospectively collected data. Cervical MRIs from a database of patients undergoing ACDF between 2015 and 2018 were retrospectively reviewed. Demographic variables included age, sex, body mass index (BMI), race, smoking status, and comorbidities such as diabetes, chronic kidney disease, and coronary artery disease. DSI2 measurements were performed on midsagittal T2-weighted MRI images by determining the intensity within regions of interest (ROI). One ROI was set in the cerebrospinal fluid (CSF) and three ROIs were set per disc at the anterior, middle, and posterior third. The mean of the three measurements per disc was then divided by that of the CSF to calculate the DSI2 score. Multivariable linear regression analyses with mixed model were conducted to determine the potential contributing factors for disc degeneration. A total of 149 patients and 770 discs were included in the final analysis. Ninety-three patients (37.6%) were female and the mean (SD) age was 55.6 (11.7) years. The distribution of DSI2 scores among the different Pfirrmann grades was as follows: Grade 1: 0.259±NA; Grade 2: 0.226±0.090; Grade 3: 0.175±0.070; Grade 4: 0.136±0.060; Grade 5: 0.131±0.050. Multivariable linear mixed-effect regression analysis, setting with DSI2 as the objective variable, demonstrated that age (β= -0.130, p< 0.05), BMI (β= -2.06, p< 0.05), Modic changes (Type1 β= -2.70, p<0.01) were independent contributors to disc degeneration. The segments C4/5 and C7/T1 were less prone to disc degeneration (C4/5: β=1.37, p<0.001; C7/T1: β= 2.63, p<0.001) and the history of diabetes (β=5.31, p<0.01) was associated with high DSI2.(p<0.01) CONCLUSIONS: The present study provides valuable insights for identifying risk factors in degenerative cervical conditions utilizing the DSI2. The DSI2 method emerges as a promising alternative for future disc research, excelling in the detection of subtle progressions of degeneration and distinguishing itself from the subjective Pfirrmann grading system.

Pengaruh Model PjBL Terhadap Hasil Belajar Siswa Kelas VIII pada Mata Pelajaran Bahasa Indonesia di MTs Muhammadiyah Padang Panjang

This study aims to determine the influence of the project-based learning model on Indonesian subjects in grade VIII at MTS Muhammadiyah Padang Panjang. This research was carried out with a quantitative research method in the form of a Quasi Experiment. There were 70 students as a sample in class VIII consisting of 35 people in the experimental class and 35 people in the control class. The data collection technique used is a test at the beginning and at the end of Indonesian learning. The data analysis techniques are normality tests, homogeneity tests, and hypothesis tests with the t-test method. The results of the study show that the application of the Project Based Learning (PjBL) learning model has an effect on the learning outcomes of grade VIII students, as evidenced by the t-test value that has been carried out using Microsoft Excel in this study of 9.395 which is greater than the ttable 1.668 at the significance level of α 0.05, meaning that Ha is accepted and Ho is rejected. There is a significant difference between the average learning outcomes of students using the PjBL learning model. Therefore, it can be concluded that the application of the Project Based Learning model has an effect on student learning outcomes in Indonesian subject grade VIII MTS Kauman Muhammadiyah Padang Panjang

Efektivitas Penggunaan Media Video Animasi Terhadap Hasil Belajar Siswa pada Mata Pelajaran IPA Kelas VIII SMP Negeri 3 Pariaman

Student learning outcomes are still low, especially in science subject grade VIII at SMP Negeri 3 Pariaman. This is because the media used by teachers in the learning process is still less varied, teachers use media in the form of printed books in which there are pictures that are difficult for students to understand. Therefore, this study aims to determine the effectiveness of the use of animated video media on student learning outcomes in science subject grade VIII at SMP Negeri 3 Pariaman. This type of research is quantitative research with an experimental approach in the form of a quasi experiment. The sample selected was class VIII.3 as a control class with 31 people and class VIII.5 as an experimental class with 31 people. This research was conducted on science subjects with human respiratory system material. The data processing used was a normality test, a homogeneity test, and a hypothesis test using the independent test method of t-test samples, with a significant level of ∝&lt;0.05. The results showed that there was a difference in learning outcomes, the experimental class with an average score of 70.48, compared to the control class with an average score of 60.38. Based on the results of the t-test calculation, t count = 2.987 while t table with a significant level ∝0.05 = 2.0003. When compared, the t calculation &gt; t table is 2.987 &gt; 2.0003. Which means that H1 is accepted, so that the effective animation video media is significantly applied to the learning outcomes of grade VIII students in science subjects at SMP Negeri 3 Pariaman

Penerapan Direct Method dalam Meningkatkan Prestasi Belajar Peserta Didik pada Mata Pelajaran Bahasa Arab Kelas 1C MTs di Pondok Pesantren Daarul Rahman Jakarta

This research is motivated by the problem of low grades in Arabic language learning subjects in class 1C MTs Daarul Rahman Islamic Boarding School, South Jakarta. The research method used is Classroom Action Research (PTK), data collection techniques with observation, oral and written tests, documentation. In this study, the subjects were students of class 1C MTs Daarul Rahman Islamic Boarding School, South Jakarta in the 2022/2023 school year consisting of 40 students. The object in this study is the improvement of students' learning achievement in Arabic language subjects using the direct method of class 1C MTs Daarul Rahman Islamic Boarding School, South Jakarta. The increase in students' learning achievement in Arabic language subjects has increased, it can be seen from each cycle that changes have occurred. In the pre-cycle the results were 62%, increased in cycle 1 with a result of 66%, and in cycle 2 increased with a result of 73%. From the learning activities that have been carried out, the learning achievement of students' Arabic language has increased and has reached the predetermined success criteria, it shows that the direct method is successful in improving students' Arabic language in class 1C MTs Daarul Rahman Islamic Boarding School, South Jakarta.

Validating scores from the short form of the Music Self-Perception Inventory (MUSPI-S) with seventh- to ninth-grade school students in Germany

The Music Self-Perception Inventory-Short (MUSPI-S) is a theoretically based instrument consisting of 28 items with subscales that assess music self-concept globally and in six specific areas. The present study sought to validate a German translation of the MUSPI-S using a sample of 444 secondary school students. In addition to participants’ scores from the German translation of the MUSPI-S, associated data included demographic background variables, self-reported school grades in various subjects, and interest in the school subject of music. Confirmatory factor analyses supported the hypothesized factor structure and measurement model for MUSPI-S scores. Latent factor correlations among MUSPI-S subscale scores and correlations of these scores with school grades and interest in the school subject of music aligned well with theoretical expectations and previous research. Findings also provided evidence for strict measurement invariance of scores in the German MUSPI-S across subgroups of gender, school year (i.e., grade level), and musical activity. MUSPI-S subscale factor-level means did not reliably differ among seventh-, eighth-, and ninth-grade students but favored females over males and musically active over non-active students on nearly all subscales. Overall, this evidence supports the use of the German translation of the MUSPI-S in assessing a wide range of important self-perceived musical abilities for research and practical assessment purposes.

Effectiveness of hybrid simulation training on medical student performance in whole-task consultation of cardiac patients: The ASSIMILATE EXCELLENCE randomized waitlist-controlled trial

BackgroundAssessment of comprehensive consultations in medicine, i.e. a complete history, physical examination, and differential diagnosis, is regarded as authentic tests of clinical competence; however, they have been shown to have low reliability and validity due to variability in the real patients used and subjective examiner grading. In the ASSIMILATE EXCELLENCE study, our aim was to assess the effect(s) of expert tuition with hybrid simulation using a simulated patient wearing a novel auscultation vest, i.e. a hybrid simulated patient, and repeated peer grading using scoring checklists on student learning, performance, and acumen in comprehensive consultations of patients with valvular heart disease.MethodsASSIMILATE EXCELLENCE was a randomized waitlist-controlled trial with blinded outcome assessment undertaken between February 2021 and November 2021. Students at the Royal College of Surgeons in Ireland in either the second or third year of the four-year graduate-entry medical degree programme were randomized to a hybrid simulation training or waitlist control group and undertook three consultation assessments of three different clinical presentations of valvular heart disease (cases: C1–C3) using hybrid simulation. Our primary outcome was the difference in total score between and within groups across time; a secondary outcome was any change in inter-rater reliability across time. Students self-reported their proficiency and confidence in comprehensive consultations using a pre- and post-study survey.ResultsIncluded were 68 students (age 27.6 ± 0.1 years; 74% women). Overall, total score was 39.6% (35.6, 44.9) in C1 and increased to 63.6% (56.7, 66.7) in C3 (P < .001). On intergroup analysis, a significant difference was observed between groups in C2 only (54.2 ± 7.1% vs. 45.6 ± 9.2%; P < .001), a finding that was mainly driven by a difference in physical examination score. On intragroup analysis, significant improvement in total score across time between cases was also observed. Intraclass correlation coefficients for each pair of assessors were excellent (0.885–0.996 [0.806, 0.998]) in all cases. Following participation, students’ confidence in comprehensive consultation assessments improved, and they felt more prepared for their future careers.ConclusionsHybrid simulation-based training improves competence and confidence in medical students undertaking comprehensive consultation assessment of cardiac patients. In addition, weighted scoring checklists improve grading consistency, learning through peer assessment, and feedback.Trial registrationClinicalTrials.gov Identifier: NCT05895799

Beyond English Instruction: A multistate analysis of Lau’s unfulfilled promise of access to core content

ABSTRACT The Lau v. Nichols Supreme Court case specifies two core responsibilities of schools – and rights for students – with regard to students classified as English learners (ELs): 1) opportunities to learn English; and 2) equitable access to grade-level content. Yet 50 years since Lau’s passage, students’ right to content may not be being upheld. Indeed, students classified as ELs may be fully excluded from classes in one or more content areas, a phenomenon called exclusionary tracking. Drawing on longitudinal, student-level data from Oregon and Michigan, we examined the prevalence of EL exclusionary tracking in grades 9–12, how it varied by subject area and grade, and the structural, organizational, and demographic predictors of exclusionary tracking. We found that many students classified as ELs were disproportionately excluded from content compared to their non-EL peers, with the largest exclusion in English language arts and science and important variation in exclusionary patterns across states and grades. Multiple factors predicted exclusionary tracking, including English proficiency level, disability status, and bilingual program participation. We discuss implications for policy and practice at the school, district, and state levels.

Representation in Brazilian classrooms: racial matching between students and teachers and school performance

ABSTRACT This study aims to analyze the impact of racial matching between teacher and student on the academic performance of middle school students in Brazil. The data comes from an educational evaluation survey carried out by the Joaquim Nabuco Foundation – Ministry of Education of Brazil (FUNDAJ 2020), which followed the same cohort of students in the sixth and seventh years of public middle schools, between the years of 2017 and 2018. To address to the potential source of endogeneity, we use FUNDAJ panel data to estimate student fixed effects models, which makes it possible to compare students who have one race-matched and one non-race-matched teacher within the same subject in the two years of data. The results show that, when placed in a situation of racial equality with their Portuguese and Mathematics teachers, Black students will present better grades in both subjects, by about 30% of their average grade. The results also show evidence of heterogeneity, with stronger effects in female students.

Pengaruh Kartu Huruf Terhadap Kemampuan Membaca Permulaan Siswa pada Mata Pelajaran Bahasa Indonesia Kelas II di Sekolah Dasar

This study aims to determine the effect of the use of letter card media on students' initial reading ability in Indonesian Language subject grade II in elementary school. This research is a quantitative research with an experimental research method with a quasi experiment type. The sample of this study was taken using a saturated sampling technique consisting of two classes, namely class II A with 20 students as a control class without using letter cards and class II B with 20 students as an experimental class using letter card media. The data collection technique used in this study is a performance test (initial reading test) using pretest and posttest. The results of the research from both classes, namely in the pretest, had an average value (Mean) of the experimental class of 52.50 and the control class of 49.69. At the time of the posttest, the average score (Mean) of the experimental class was 80.94 and the control class was 59.69. The results of the hypothesis show that the tcount value &gt; the table is 5,146 &gt; 1,684 which means that H0 is rejected and H1 is accepted. So, the hypothesis states that the letter card media has an effect on students' initial reading ability in Indonesian subjects grade II at UPT SDN 060816 Medan.